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Kidney insufficiency treatments

What does dialysis consist in?

Dialysis covers a set of techniques which allows your blood to be purified so as to get rid of the toxins and water that your ill kidneys cannot eliminate anymore.

Various dialysis techniques are available.

Hemodialysis

This therapy consists in purifying the blood by means of a special apparatus and a filtering system in order to make up for the permanent functioning of your kidneys which are no longer operational. To access the vessels, an arteriovenous fistula must be created at least 3 weeks prior to the actual treatment.

Hemodialysis is an intermittent treatment (3 weekly sessions, each lasting in general at least 4 hours).In all cases and particularly at the beginning of the treatment, the session can take place in a dedicated center. Later, if your health status and autonomy allow, and after a specific training, it can take place in an auto-dialysis unit or at your home.
During the sessions, your nephrology follow-up will be ensured at the Center on a regular basis whether you are under auto-dialysis or treated at home. During visits or consultations by the nephrologist, you are invited to share all relevant information on your health status and ask any question in relation with your treatment. Your medical care requires a qualified staff working under the responsibility of the nephrologist.

Our dialysis generators (machines) are sterilized and checked prior to each use.
Instruments in direct and permanent contact with your blood during the session are only used once.

What are the risks incurred by hemodialysis?

Complications linked to your vascular access, in other words the risk of bacterial or viral infections, thrombosis and hemorrhage which is common in fistula areas and with dialysis catheters. The protection of your venous capital is what matters to your nephrologist.

Risk of hemorrhage: the anticoagulant treatment which prevents your blood from coagulating inside the dialysis circuit leads to a risk of hemorrhage. At all times, you should point out any hemorrhagic tendency, and prior to any operation (outside of the dialysis itself) you should specify that you are under dialysis.

Today, the conditions of hemodialysis surveillance make it possible to rapidly detect and solve any anomaly during a session. Nausea, vomiting and dizziness may be a sign of a drop in blood pressure. Should this occur, the medical team needs to be informed so as to take all necessary measures. Also, by respecting hygiene and dietary rules, one minimizes hypotension risks.
Following a hemodialysis session, a brief fatigue may arise and last a few hours. Should this problem persist any longer, you should inform the nephrologist who will have your treatment modified. It should be noted that unpredictable complications with a vital risk have become rare.

Peritoneal dialysis

This method is performed at home on a daily basis after a training period in a specialized structure. It requires the installation of a catheter (tube) inside the abdominal cavity.
Drastic hygiene as well as a good patient autonomy are also requested.

What are the risks incurred by peritoneal dialysis?

peritoneal infections or peritonitis

worsening of malnutrition problems

insufficient purification (malfunction of the catheter and/or of the patient’s peritoneum, disappearance of diuresis)

Choosing a treatment

The treatment should be determined according to your state of health, your relatives, and your own informed choice. Should it be possible to consider a transplant in the end, you will be advised and all information on general modalities will be given to you.

Kidney transplant

Kidney transplantation is an option for all patients suffering from chronic kidney insufficiency, whether already under dialysis or with pending sessions, provided that they submit a request, and in the absence of medical contraindication. The patient must undergo a pre-transplantation check-up before he can request to be registered and put on a waiting list. This registration is validated by the French transplantation authority (Etablissement Français des Greffes).

Kidney transplantation is what brings a patient as close as possible to the recovery of a normal renal function. It increases life expectancy and improves the patient’s quality of life. However, one should take into consideration the possibility of a long waiting time before a compatible organ is available.

This surgical operation consists in replacing the kidney which no longer works by the donor’s healthy organ. The latter can either be deceased or brain-dead. He may also be a living relative (spouse, sibling, parents…).

After the transplant, a regular medical follow-up and daily anti-rejection drug treatment with possible side-effects are necessary.

Associated treatments

What about following a diet

Hygiene and dietary recommendations complying with your new treatment will be given to you by your nephrologist. By following a few hygiene and dietary rules, you will improve the efficiency of your treatment and reduce the risk of complications.

What about blood transfusion?

It is quite likely that in the course of your dialysis treatment you may need to be transfused.
You will therefore receive specific information on transfusion and its associated risks and follow-up.
At some point, you will be asked to notify your consent.

What about vaccination?

From the day of your arrival onwards, a follow-up of vaccinations will be carried out.
Vaccination against hepatitis B will be systematically proposed and regular serological tests will be carried out.

Hepatitis C is not taken into account in our preventive vaccination policy. Its screening is carried out through regular serological tests.

What about biological health check-ups

When possible, biological check-ups will be carried out during dialysis sessions in order to avoid useless punctures.

In order to avoid any contraindication, it is important that you keep the medical team informed of your treatment as well as any related modification which might be prescribed outside the center.